NURS 6675 Week 1 Nurse Practitioner Professional Issues

NURS 6675 Week 1 Nurse Practitioner Professional Issues

Week 1 Discussion Post- Tiffany Edwards Attachment

COLLAPSE
Certification and Licensure Plan

The role of the Mississippi Board of Nursing is to provide rules and regulations for the licensure of registered nurses and advanced practice registered nurses. The function of the board also includes regulating the practice of nursing by establishing scope of practice. Nurse Practitioner’s (NP) shall practice according to the standards and guidelines of the national certification organization for which they are certified (Mississippi Board of Nursing [MSBON], n.d.).

Does Mississippi require physician collaboration or supervision for nurse practitioners, and if so, what are those requirements?

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Mississippi State law requires that Nurse Practitioners practice in collaboration with a physician. Each physician can supervise no more than four drug-prescribing Nurse Practitioner\’s. Practitioners must collaborate with one or more doctors within 75 miles of the NP\’s clinic (MSBON, n.d.). However, the collaborating physician does not need to be present with the NP when the services are furnished or to make an independent evaluation of each patient who is seen by the NP.

Collaborating physician\’s and nurse practitioners must have jointly-developed, written protocols covering all major elements of practice. The supervising physician is then required to randomly review up to 20 of the nurse practitioner’s patient charts and meet with the nurse practitioner once every quarter (MSBON, n.d.).

How do you get certified and licensed as an Advanced Practice Registered Nurse (APRN) in Mississippi?

A prospective advanced practice nurse must earn a degree at the master\’s level or higher. The program is to include clinical experience. It is to be nationally accredited through an agency approved by the Board. Once an NP completes a Master’s leveled agree from an approved and accredited educational institution, certification must be obtained. Certification is obtained by sitting for a National Board Certified examination that consist of questions for perspective course of study (MSBON, n.d.).

Any nurse desiring to be certified as an advanced practice registered nurse shall apply to the board and submit proof that he or she holds a current license to practice professional nursing and that he or she meets one or more of the following requirements: satisfactory completion of a formal post-basic educational program of at least one academic year, certification by a board-approved certifying body, or graduation from a program leading to a master\’s or post-master\’s degree in a nursing clinical specialty area with preparation in specialized practitioner skills.

Applicants for Mississippi Board of Nursing (Board) APRN certification must be currently licensed as a Registered Nurse in Mississippi or hold an active unrestricted Registered Nurse multi-state Compact license. Applicants for licensure must submit an online application on Nurse gateway. The initial fee for licensure is $100 in addition to a $75 background check fee, and $100 Controlled Substance Prescriptive Authority fee (MSBON, n.d.).

The MS licensure process is done online and requires the following documentation: proof of RN license, proof of national nurse practitioner certification, official transcript from an accredited nurse practitioner program, verification of the protocol/practice for each physician with whom you have entered into a collaborative practice agreement, completion of a fingerprint-based criminal background check (MSBON, n.d.). The candidates NP license is renewed every two years and Certification is renewed every five years.

Initially, to get licensed, a candidate must have a certain number of practice hours prior to a license being obtained. However, the MS Board of Nursing Board of Directors met in 2021 during the peak of COVID-19, and voted to repeal Part 2840, Chapter 1, Rule 1.3 Monitored Practice Hours by an emergency temporary rule. Therefore, monitored hours for APRNs are no longer required to practice in Mississippi. All other licensure requirements pursuant to Miss. Code Ann. Section 73-15-20 (7) and 30 Miss. Admin. Code Part 2840 continue to be mandatory for APRNs to practice in the state of Mississippi.

What is the application process for certification in Mississippi?

NP’s are required by state law to take and pass a national certification exam. The candidate must have completed a master’s degree to sit for the certification examination. The applicant must access the MS BON website or go to https://gateway.licensure.msbn.ms.gov/ . Once site is accessed, candidate must register with demographic information. In addition, candidate must verify graduation from an accredited school, submit an official transcript, and verify that a collaborative agreement has been made or in the process of being made with a Physician (MSBON, n.d.).

What is the Mississippi board of nursing website?

The Mississippi Board of Nursing website is https://www.msbn.ms.gov/.

How does Mississippi define the scope of practice of a nurse practitioner?

According to the Mississippi Nursing Practice Law §73-15-20(3), NP’s working in the state of MS are under reduced practice. State law modifies patient access to nurse practitioner (NP) care. NPs are required by law to maintain a regulated collaborative agreement with a physician for at least one element of NP practice (AANP, 2020). NP’s may diagnose, treat, and manage medical conditions. This can also include prescriptive authority as identified by the MSBON (Buppert, 2021).

What is included in Mississippi’s state practice agreement?

Mississippi limits the ability of nurse practitioners to practice up to their full training. In Mississippi, the APRN is responsible for gaining approval for practice site & collaborative physician through Board of Nursing prior to beginning to practice. The designated physical location in Mississippi which is usually the practice location must be reported to the Board to conduct a site visit to evaluate the delivery of care by a licensee and compliance with laws and regulations regarding delivery of care by a licensee (MSBON, n.d.).

How do you get a DEA license?

Every certified APRN authorized to practice in Mississippi who prescribes any controlled substances (Schedules II, Ill, IV, or V) within Mississippi or who proposes to engage in the prescribing of any controlled substance within Mississippi must be registered with the U.S. Drug Enforcement Administration (DEA) in compliance with Title 21 CFR Part 1301 Food and Drugs, and must also apply for this privilege with the Mississippi Board of Nursing. DEA registration can only be done after being issued prescriptive authority by the MBON.

Registration occurs online at https://www.deadiversion.usdoj.gov (DEA, 2020). The applicant must pay the applicable fees and enter APRN license number on the application as the applicant will not have a state controlled substance number (MSBON, n.d.).

Does Mississippi have a prescription monitoring program (PMP)?

Yes, Mississippi does have a prescription monitoring. The NP can register online after passing boards, receiving licensure, and a DEA number.

How does Mississippi describe a nurse practitioner’s controlled-substance prescriptive authority, and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?

In the state of Mississippi, NP prescribing protocols must be approved by the Board of Nursing and physician involvement is required for NP prescriptive authority. Additional educational requirements for NP prescriptive authority include completion of a Board approved educational program prior to making application for controlled substance authority (American Medical Association, 2017).

NP’s must also submit to the BON documentation of at least 40 contact hours related to the advanced clinical practice of the NP within the last 2 years. Two of these hours must be directly related to the prescription of controlled substances. NP’s have authority to prescribe schedule II-V controlled substances (American Medical Association, 2017).

Explain the types of regulations that exist and the barriers that may impact nurse practitioner independent practice in Mississippi. Describe what surprised you from your research.

MS State licensure regulates NP practice and is a barrier to NPs practicing to the fullest extent of their education and training. NP’s must practice under restricted authority, which in the author’s opinion significantly reduces their efficiency and ability to provide patients with the needed care. Allowing NP’s to practice under full authority can have benefits including mitigating and closing the gap on limited access to care (Peterson, 2017).

Conclusion

In conclusion, safe and competent practice is ensured through regulation. When medical professionals thoroughly understand and comply with all regulations and standards, they practice with confidence, which is reflected in the care they provide to their patients (Ortiz et al., 2018). NP’s are set to play key roles in improving health outcomes of diverse populations.

NURS 6675 Week 1 Nurse Practitioner Professional Issues References

American Association of Nurse Practitioners [AANP]. (2020). State practice environment. 
https://www.aanp.org/advocacy/state/state-practice-environment

American Medical Association. (2017). State Law Chart: Nurse Practitioner Prescriptive 
Authority. Retrieved June 1, 2022, from https://www.ama-assn.org/sites/ama-
assn.org/files/corp/media-browser/specialty%20group/arc/ama-chart-np-prescriptive-
authority.pdf

Buppert, C. (2021). Nurse practitioner\’s business practice and legal guide (7th ed.). Jones & 
Bartlett Learning.

Drug Enforcement Administration Diversion Control Division [DEA]. (2020). Registration. 
https://www.deadiversion.usdoj.gov/drugreg/index.html

Mississippi Board of Nursing [MSBON]. (n.d.). Practice and licensure. 
https://www.msbn.ms.gov/

Ortiz, J., Hofler, R., Bushy, A., Lin, Y. L., Khanijahani, A., & Bitney, A. (2018). Impact of 
Nurse Practitioner Practice Regulations on Rural Population Health Outcomes. Healthcare (Basel, Switzerland), 6(2), 65. https://doi.org/10.3390/healthcare6020065

Peterson, M. E. (2017). Barriers to Practice and the Impact on Health Care: A Nurse Practitioner Focus. Journal of the advanced practitioner in oncology, 8(1), 74–81. NURS 6675 Week 1 Nurse Practitioner Professional Issues

Week 1: Nurse Practitioner Professional Issues Questions

Psychiatric-mental health nurse practitioners are committed to the assessment, diagnosis, and treatment of psychiatric disorders in individuals and groups through psychotherapy and medication. Since the role of the PMHNP carries such responsibility, it is no surprise that there is a rigorous path to obtain and maintain your PMHNP certification and licensure.

PMHNPs currently have only one choice for certification, which is through the American Nurses Credentialing Center (ANCC). The ANCC offers the “psychiatric/mental-health nurse practitioner (across the lifespan)” board certification (PMHNP-BC). In many states, board certification is a necessary prerequisite to receiving an NP license. Even if board certification is not a requirement for state licensure, it may be a requirement to receive privileges in various hospitals and other health care facilities. Malpractice insurance providers may also require board certification prior to issuing coverage to NPs.

This week, you will review your state specific PMHNP certification and licensure requirements and scope of practice, as well as prescriptive authority issues.

Learning Objectives

Students will:

Summarize nurse practitioner certification and licensure processes
Explain state-specific scope of practice for psychiatric-mental health nurse practitioners
Explain state-specific restrictions or limitations for practice
Explain nurse practitioner prescriptive authority and DEA registration processes

Learning Resources

Required Readings (click to expand/reduce)

American Association of Nurse Practitioners. (2020). State practice environment. https://www.aanp.org/advocacy/state/state-practice-environment

On the map on the webpage, click on your state and review. After you complete the PMHNP Program, pass the certification exam, and get a job, you will need to revisit this website to apply for the privilege to practice as an APRN with your state Board of Nursing.

American Psychiatric Association. (2020). Telepsychiatry. https://www.psychiatry.org/psychiatrists/practice/telepsychiatry

Buppert, C. (2021). Nurse practitioner\’s business practice and legal guide (7th ed.). Jones & Bartlett Learning. NURS 6675 Week 1 Nurse Practitioner Professional Issues

Chapter 1, “What Is a Nurse Practitioner?”
Chapter 2, “Nurse Practitioner Scope of Practice”
Chapter 3, “State Regulation of the Nurse Practitioner Practice”
Chapter 4, “Federal Regulation of the Nurse Practitioner Profession”
Chapter 5, “Prescribing”
Centers for Disease Control and Prevention. (2020). Using telehealth to expand access to essential health services during the COVID-19 pandemic. https://www.cdc.gov/coronavirus/2019-ncov/hcp/telehealth.html

Centers for Medicare & Medicaid Services. (2019). National provider identifier standard (NPI). https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions.
Drug Enforcement Administration Diversion Control Division. (2020). Registration. https://www.deadiversion.usdoj.gov/drugreg/index.html

This site contains information about applying for your DEA registration number. This number is required for writing prescriptions.

After completing PMHNP Program and passing the PMHNP certification exam, complete the DEA application to request prescriptive privileges. Your DEA number will be renewable every five years.

National Panel for Psychiatric Mental Health NP Competencies. (2003). Psychiatric-mental health nurse practitioner competencies. National Organization of Nurse Practitioner Faculties (NONPF). https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/imported/PMHNPcomps03.pdf

Stewart, J. G., & DeNisco, S. M. (2019). Role development for the nurse practitioner (2nd ed.). Jones & Bartlett Learning.

Chapter 1, “Historical Perspectives: The Art and Science of Nurse Practitionering”
Nurse Practitioner Core Competencies
Nurse Practitioners’ Unique Role
Chapter 13, “Quality, Safety, and Prescriptive Authority”
Substance Abuse and Mental Health Services Administration. (2020). Become a buprenorphine waivered practitioner. https://www.samhsa.gov/medication-assisted-treatment/buprenorphine-waiver-management/apply-for-practitioner-waiver

This site contains information about applying for a practitioner waiver to prescribe or dispense buprenorphine under the Drug Addiction Treatment Act of 2000 (DATA 2000).

After you obtain a Drug Enforcement Agency (DEA) number and completed 24-hour medication-assisted treatment (MAT) waiver training, you may apply to Substance Abuse and Mental Health Services Administration (SAMSHA) for MAT waiver to be able to prescribe Schedule III, IV, or V opioid drugs for the maintenance and detoxification treatment of opioid use disorders relapse prevention.

Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.

Chapter 2, “The Role of the Psychiatric-Mental Health Nurse Practitioner: Regulations and Scope of Practice”
Chapter 3, “Theoretical Foundations of Care and Nonpharmacological Therapies” NURS 6675 Week 1 Nurse Practitioner Professional Issues

Recommended Resources

Consult these professional organization websites as needed.

American Psychiatric Nurse Association (APNA) https://www.apna.org

International Society of Psychiatric-Mental Health Nurses (ISPN) www.ispn-psych.org

National Alliance on Mental Illness (NAMI) https://www.nami.org

National Council for Behavioral Health (NCBH) www.thenationalcouncil.org

National Institute of Mental Health (NIMH) https://www.nimh.nih.gov/index.shtml

Substance Abuse and Mental Health Services Administration (SAMHSA) www.samhsa.gov

PMHNP Study Support Lounge

The PMHNP Study Support Lounge is offered throughout the course as a place of academic refuge, where you can ask questions, offer insights, and interact with your peers. Your Instructor may also weigh in to provide collective feedback to the group based on trends, common problems, and common strengths in student posts.

Photo Credit: [Jacob Ammentorp Lund]/[iStock / Getty Images Plus]/Getty Images

As a peer, you are encouraged to provide constructive helpful feedback. Advanced practice nurses always benefit from the feedback of others. Your Study Support Lounge posts may be procedural (“How do I attach a Kaltura video to a Discussion post?”), conceptual (“How does this relate to the other therapy approaches we have studied?”), or analytical (“What do these diagnostic results actually mean in the context of this specific patient case?”). Although not mandatory, this is an opportunity to interact and study together as you navigate the assignments, so you are highly encouraged to take part in this activity. Full participation in activities like this is a statistically significant predictor of success.

To Participate in this Optional Discussion:

PMHNP Study Support Lounge

Acknowledgment
Practicum Manual Acknowledgment
The Practicum Manual describes the structure and timing of the classroom-based and practicum experiences and the policies students must follow to be successful in the nurse practitioner (NP) specialties.

Field Experience: MSN Nurse Practitioner Practicum Manual

Click here and follow the instructions to confirm you have downloaded and read the entire MSN Nurse Practitioner Practicum Manual and will abide by the requirements described in order to successfully complete this program.

Discussion: Certification and Licensure Plan

NURS 6675 Week 1 Nurse Practitioner Professional Issues

Now that you are in the final course in your program, it is time to turn in earnest to preparing for certification and licensure. You will need to take and pass the national PMHNP certification exam. Once certified, you will then be eligible to apply for licensure as an advanced practice registered nurse (APRN) in the state desired. It will be up to you to ensure you are knowledgeable about the practice agreements, scope of practice, and prescriptive authority in your state.

Photo Credit: AndreyPopov / iStock / Getty Images Plus / Getty Images

Although a movement called the APRN Consensus Model is attempting to standardize NP regulations nationally, it is still the case that requirements vary state to state. In some states, NPs may establish an independent practice without the supervision of an MD. Additionally, states are currently categorized as either allowing full practice, reduced practice, or restricted practice. Full practice states allow NPs to evaluate, order diagnostics, diagnose, and treat patients. They are licensed under the exclusive authority of the state board of nursing for the appropriate state. Many states may require prescriptive authority protocols in addition to collaborative agreement.

Another important area to consider and plan for is prescriptive authority. The appropriate board, which may be the medical board, state board of pharmacy, or nursing board, grants prescriptive authority under state law for the appropriate state licensure. The federal government grants the authority to write for a controlled substance, and the Drug Enforcement Administration (DEA) verifies this action through by the appropriate state board. Drug Enforcement Agency registration is granted at the federal level and has additional requirements/fees for the registration process.

In this Discussion, you will locate and review the practice agreements in the state in which you plan to practice, identify potential collaboration requirements in your state, and understand the certification and licensing process that you will need to follow.

To Prepare:

Review practice agreements in your state.
Identify whether your state requires physician collaboration or supervision for nurse practitioners, and if so, what those requirements are.
Research the following:
How do you get certified and licensed as an Advanced Practice Registered Nurse (APRN) in your state?
What is the application process for certification in your state?
What is your state’s board of nursing website?
How does your state define the scope of practice of a nurse practitioner?
What is included in your state practice agreement?
How do you get a DEA license?
Does your state have a prescription monitoring program (PMP)?
How does your state describe a nurse practitioner’s controlled-substance prescriptive authority, and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?

By Day 3 of Week 1

Post a summary of your findings on your state based on the questions listed above. Explain the types of regulations that exist and the barriers that may impact nurse practitioner independent practice in your state. Be specific. Also, describe what surprised you from your research.

Read a selection of your colleagues’ responses.

By Day 6 of Week 1

Respond to at least two of your colleagues on 2 different days in one or more of the ways listed below.

Share an insight from having viewed your colleagues’ posts.
Suggest additional actions or perspectives.
Share insights after comparing state processes, roles, and limitations.
Suggest a way to advocate for the profession.
Share resources with those who are in your state.
Note: For this Discussion, you are required to complete your initial post before you can view and respond to your colleagues’ postings. Begin by clicking on the \”Post to Discussion Question\” link, and then select \”Create Thread\” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!